HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Appendix Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kandala, N.-B. Articles by Cappuccio, F. P. Search for Related Content PubMed PubMed Citation Articles by Kandala, N.-B. Articles by Cappuccio, F. P. Related Collections Program Management Epidemiology Geographic Information Systems (GIS)

Spatial Analysis of Risk Factors for Childhood Morbidity in Nigeria

Recent Demographic and Health Surveys (DHS) from Sub-Saharan Africa (SSA) indicate a decline in childhood vaccination coverage but a high prevalence of childhood diarrhea, cough, and fever. We used Nigerian DHS data to investigate the impact of geographical factors and other important risk factors on diarrhea, cough, and fever using geoadditive Bayesian semiparametric models. A higher prevalence of childhood diarrhea, cough, and fever is observed in the northern and eastern states, while lower disease prevalence is observed in the western and southern states. In addition, children from mothers with higher levels of education and those from poor households had a significantly lower association with diarrhea; children delivered in hospitals, living in urban areas, or from mothers having received prenatal visits had a significantly lower association with fever. Our maps are a novel and relevant tool to help local governments to improve health-care interventions and achieve Millennium Development Goals (MDG4).

Received February 25, 2007. Accepted for publication June 13, 2007.

Acknowledgments: The authors thank participants at seminars in Warwick and at the BIOMETRIC Conference in Montreal and the British Population Conference in Southampton for helpful comments and discussions. We also thank Macro Int. for providing free data sets for Nigeria.

Financial support: This work is supported by the UK Economic & Social Research Council (ESRC, grant no. RES-000-22-1221).

^* Address correspondence to Ngianga-Bakwin Kandala, Clifford Road Bridge, Clinical Sciences Research Institute, Warwick Medical School, Coventry CV2 2DX, United Kingdom. E-mail: N-B.kandala{at}warwick.ac.ukdiseases

Authors’ addresses: Ngianga-Bakwin Kandala, Chen Ji, Saverio Stranges, and Francesco P. Cappuccio, Clinical Sciences Research Institute, Warwick Medical School, Coventry CV2 2DX, U.K., Telephone: +44 (0)24 76968669, Fax: +44 (0)24 76968660, E-mail: N-B.Kandala{at}warwick.ac.uk. Nigel Stallard, Health Sciences Research Institute, Warwick Medical School, Coventry CV4 7AL, U.K.

Contributions: N.-B. Kandala—conception and design; literature review; data analysis and interpretation; drafting the article; approval of final article for submission. C. Ji—literature review; data analysis and interpretation; drafting the article. N. Stallard—interpretation of results; critical revisions for important intellectual content; approval of final article for submission. S. Stranges—interpretation of results; critical revisions for important intellectual content. F.P. Cappuccio—interpretation of results; critical revisions for important intellectual content; approval of final article for submission.

Reprint requests: Ngianga-Bakwin Kandala, Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, U.K., Telephone: +44 (0)24 76968669, Fax: +44 (0)24 76968660, E-mail: N-B.Kandala{at}warwick.ac.uk.